Surgical gown



Dec. 26, 1967 R. J. ROTANZ ETAL 3,359,569

SURGI CAL GOWN Filed April 12, 1966 4 Sheets-Sheet l z N mg N Va EN f 5%Z 3% 3 6 M X ATTORNEY 1967 R. J. ROTANZ ETAL 3,

SURGICAL GOWN Filed April 12, 1966 4 Sheets-Sheet 2 ATTORNEY Dec. 26,1967 R. J- ROTANZ ETAL 3,359,569

SURGICAL GOWN 4 Sheets-Sheet 5 Filed April 12, 1966 FINVENTOR L/OJEPH//,4/v4 0N 650/9 5 M SQQ/I/E/VS ROBERT J P0 TA/VZ ATTORNEY Dec. 26, 1967R. J. ROTANZ ETAL 3,359,569

SURGICAL GOWN Filed April 12, 1966 4 Sheets-Sheet 4 INVENTORS. doss/v/ A///4'/VZON 6504 -5 Jaw/yams FOBEIG'T d. Par/4N2 ATTORNEY United StatesPatent 3,359,569 SURGICAL GOWN Robert J. Rotanz, Somerset, George W.Scrlvens, Edison, and Joseph F. Hanlon, Rocky Hill, N.J., assignors toJohnson & Johnson, a corporation of New Jersey Filed Apr. 12, 1966, Ser.No. 542,091 16 Claims. (Cl. 2114) This invention relates to surgicalgowns and the like and in particular to surgical gowns designed tofacilitate the aseptic gowning of operating room personnel and tominimize the passage of fluids through the gown.

The surgeons sterile gown plays an important role in surgicalprocedures, the same functioning to prevent contamination of thepatient, surgical instruments, and other personnel through contact withthe wearer and to prevent the underclothes of the wearer from becomingsaturated with blood and other fluids. Surgical gowns of prior designhave been inadequate in a number of ways.

First, in most hospitals, the conventional sterilized back closingsurgical gown is folded in such a way that essentially only interiorsurfaces of the gown face outward when the folded gown is placed on autility table, however, the gown is not otherwise folded with a viewtoward aseptic application. The nonsterile circulating nurse inattempting to open the gown while grasping only internal surfaces of thesame must carefully chose the proper hand grasping positions, thusconsuming valuable time, to insure that as the gown falls open she willnot inadvertently touch exterior surfaces of the same. In addition, whenthe nurse grasps the proper interior surfaces of a gown folded in thisconventional manner and lifts it from the sable to hold it for thesurgeon to insert his arms into the sleeves, it unfolds and portions ofthe gown may fall below waist and/ or table level, these portions thenbeing deemed to be contaminated.

Second, surgical gowns, as indicated above, have been generally the backclosing type, the same usually being closed by virtue of drawstrings orthe like which are tied by the circulating nurse. Since the circulatingnurse is nonsterile, the portion of the gown adjacent the drawstrings,and the drawstrings themselves, are considered contaminated. Frequentlyduring operations, a surgeon may back into one of his associates thuscausing the front and and critical portion of the associates gown tobecome contaminated. In order to avoid this contamination, it has beensuggested to drape a bib over the back of the surgeons gown to cover thecontaminated area, the bib being secured by strings tied in the front ofthe surgeon by the surgeon. However, this is time consuming and adds tothe discomfort of the surgeon.

Third, surgical gowns usually have been designed for use in conjunctionwith a belt broght about the midsection to insure a snug fit for personsof different size and to prevent billowing of the gown during surgery.These belts are usually tightly rolled, to prevent the belt fromtouching nonsterile surfaces during the gowning procedure, andpermanently attached to the back of the gown. The surgeon must thereforereach around his back to grasp the belt, bring it to his front and thensecure the same. Since the back of the gown has previously beenconsidered to be nonsterile for the reasons noted above, it isundesirable for the surgeon to reach around behind his back. If such abelt is positioned on the front of the surgical gown, it is stillnecessary to pass the same around behind the surgeon again causingcontamination of the same either by the surgeon reaching behind his backor by the circulating nurse touching the belt.

Fourth, surgical gowns have generally been made from materials which arenot fluid repellent and have had only a single thickness of material inthe central front area of the gown. During surgery the gowns becomesaturated with blood and this blood is wicked through the single layerof nonrepellent material wetting the underclothes and the skin of thesurgeon. Microorganisms present on the skin of the surgeon or hisunderclothes may then be carried outward through the capillary channelsto the surface of the gown thus contaminating the same.

It is therefore one object of this invention to provide a surgical gownfolded so that it may, with certainty, be lifted from a utility table asa unit without unfolding While grasping only interior "surfaces of thegown and without inadvertently touching any exterior surfaces, and whichmay subsequently be opened by a simple motion such as shaking, and inparticular a folded gown in which the proper hand grasping areas aredefined by a plurality of pockets on the outer surface of the foldedunit.

It is a second object of this invention to provide a gown which may bequickly put on the surgeon and closed without requiring the touching ofany exterior surfaces of the gown by unsterile personnel and further toprovide a gown which the surgeon may secure himself.

It is a third object of this invention to provide a folded belt unitwhich may be temporarily secured to the surgical gown so that it willnot drop to the floor when the gown is opened but which can be removedfrom the gown and put on without the surgeon reaching behind his backand without the circulating nurse touching any part of the sterile gownor belt.

It is a fourth object of this invention to provide a surgical gownhaving a double layer of fluid repellent material in the centraloperative field, the layers preferably being secured together onlyoutward of the central operative field to avoid needle holes in thecentral operative field.

According to this invention, surgical g'owns are provided whicheliminate the problems hereinbefore discussed and fulfill theseobjectives. The design of these gowns will be best understood byreference to the accompanying drawings and following descriptions in thedrawings.

FIG. 1 is a plan view of a front closing surgical gown of this inventionadditionally showing the first step in folding the gown;

FIG. 2 shows the second and third steps of folding the gown illustratedin FIG. 1;

FIG. 3 is a plan view of the gown after the folding has been completed;

FIG. 4 is another plan view of the folded gown showing particularly theposition and function of the sleeves in the fold;

FIG. 5 is a view in perspective of the folded gown illustrating theproper positioning of the hands prior to lifting the gown from thetable;

FIG. 6 illustrates the folded gown after it has been lifted from thetable;

FIG. 7 illustrates the surgical gown after it has been opened and priorto its being put on by the surgeon;

FIG. 8 illustrates the first step in closing the front closing gownshown in FIG. 1;

FIG. 9 illustrates the final step in the gowning procedure;

FIG. 10 is a front exterior plan view of a back closing surgical gownincorporating the feature of this invention;

FIG. 11 is an interior plan view of the front portion of the gown ofFIG. 10;

FIG. 12 is a view in perspective of a belt unit for use in conjunctionwith the gowns of FIG. 1 and FIG. 10;

FIG. 13 is another view of the belt unit showing the manner in which thebelt is folded;

FIG. 14 illustrates the method of using the belt unit of FIG. 12;

FIG. 15 shows the belt of FIG. 12 in use with a gown of this invention.

Referring now specifically to FIG. 1 there is illustrated a frontclosing surgical gown 1. The gown comprises a main sheet 2 and sleeves 3integrally fastened thereto, the main sheet 2 having back portion 14with side edges 6a and 7a and front portion 13 having left and rightflaps and 4 with generally longitudinally extending edges 6 and 7. Apair of pockets 8 and 8 are located adjacent the neck band 9 and edges 6and 7. One portion 10 of a pressure sensitive closure is secured to oneshoulder of 'the gown and the second portion 11 of the pressuresensitive closure is secured to the interior surface of left flap 5underlying pocket 8. A tab 12 is detachably secured by virtue of steelclip 21 to the outer surface of the left flap 5 at the edge of pocket 8and overlying the closure 11.

In folding the gown, left flap 5 and right flap 4 are folded back andoutward upon themselves as shown in FIG. 2 so as to essentially overlieside edges 6a and 7a and so that only interior surfaces of the flaps areexposed.

The bottom 15 of the gown is folded upward upon itself first along foldline F1 and then along fold line F2, as shown in FIGS. 2 and 3 to form aseries of underlying folds 19, bestseen in FIG. 5. The sleeves 3 arefolded in half inward and are tucked between two of the underlying folds19 as shown most clearly in FIGS. 4 and 5.

Referring now specifically to FIG. 5, by virtue of this folding, a pairof pockets 16 and 17 are formed on the top surface of the folded unitand, except for areas 18 along the top of the sleeves, only interiorsurfaces of the folded gown are exposed. Thus, the circulating nurse mayinsert her hands into the pockets as shown in FIG. 5 without any dangerof touching exterior surfaces of the gown and may lift the entire unithigh above the supporting table as shown in FIG. 6 without the samebecoming unfolded, the sleeves 3 serving to secure the underlying folds19 to the top 20 of the gown. By shaking the folded unit, the nurse maycause sleeves 3 to fall out from its tucked position and the gown toopen as shown in FIG. 7.

In some cases, it may be desirable to provide a gown which may be liftedfrom the table without unfolding but which may be subsequently openedwithout shaking. In this case the sleeves 3 would be tucked between thetop 20 of the gown and the set of underlying folds 19 instead of betweena pair of the underlying folds 19, and the folded unit shown in FIG. 5further folded in half backward on itself along fold line F3 so that thepockets 16 and 17 are on opposing sides of the folded unit.

Once the gown is unfolded, various alternate procedures are suitablyfollowed. In the case of the front opening gown illustrated, the nursemay hold the gown as shown in FIG. 7 while the surgeon inserts his rightarm into the right sleeve and then move out of the way of the surgeon byholding the tab 12 while the surgeon puts his left arm into the leftsleeve. In order to prevent the overlying portions of the flaps 4 and 5from falling outward, these portions should be detachably secured to theremainder of the gown as by the piece of tape 25.

This fold may also be used in conjunction with gowns other than frontclosing gowns. In the case of a back closing gown, the gown wearer wouldperform the functions performed by the nurse in FIGS. 5 through 7. Thesurgeon would insert his hands in the pockets 16 and 17 as shown in FIG.5, lift the gown from the table, and shake the same to cause it to openas shown in FIGS. 6 and 7, and then being in the same position as thenurse shown in FIG. 7, would slip his arms into the sleeves.

Once the surgeon has inserted his arms in the sleeves, other advantagesof the gown design become important. Referring again to the frontopening gown and particularly to FIG. 8, the surgeon, being in a sterilecondition, may place his gloved hands within the pockets 8 and 8,

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slip the right flap 4 under the left flap 5 and press the portion 11 ofthe pressure sensitive closure underlying the pocket 8 against portion10 of the closure, this latter step being shown in FIG. 9.

If the gown is to be closed by an assistant rather than by the wearer,the assistant may place one hand in the pocket 8' on the right flap 4,slip the same under the left flap 5 as the wearer is doing in FIG. 8,and then grasp the tab 12 on the left flap 5 and pull the left flap 5across the right flap 4 contacting the two portions 10 and 11 of thepressure sensitive closure. Since the area surrounding pocket 8 is anunderlying surface, the nonsterile nurse may properly touch the same.The tab 12 as previously mentioned is detachably secured to the gown byvirtue of clip 21 so that a small force in the plane of flap 5 after thegown has been closed will separate the contaminated tab from the gown.

The tab 12 preferably consists of the folded belt unit 100, illustratedin FIGS. 12 through 14, for use in conjunction with the wearing of thegown, the belt 102 being folded into a compact unit and enclosed in asterile overwrap 163. By attaching the belt which is to be used inconjunction with the gown to the gown itself, there is little danger ofthe belt falling to the floor when the package is opened, and the nurseor surgeon may grasp the belt tab and remove the same in essentially thesame motion as that used for closing the gown.

By virtue of the pocket, tab and underlying closure, the gownillustrated and described may be put on without touching any exteriorportion of the gown. The drawstrings used on conventional gowns and thetying of the same drawstrings in the back of the gown and the resultantcontamination of the gown are eliminated, the particular gown shownbeing optionally aseptically closed either by the surgeon himself or byan assistant.

The pockets 8 and 8 :and/ or the tab 12 and the closure 10 and 11 neednot be positioned in the upper corner of the front flaps 4 or 5 of thegown although this positioning best facilitates the aseptic closing ofthe gown. A number of pockets and/or tabs and closures may be providedvertically so that the gown may be secured at a number of positions. Anumber of closures or pockets may also be provided horizontally toenable simple aseptic adjustment of the girth of the gown.

While use of pockets and/or tabs and closures has been described andillustrated with respect to a front closing gown, these inventiveconcepts may be incorporated into a back or side closing gown. In thecase of a back closing gown, the pockets would suitably be eliminated,since it would be impossible for the surgeon to close the gown himselfand since it is not desirable for the nonsterile nurse to touch theexterior surfaces to the gown. The aseptic closing of the back of thegown would therefore be suitably accomplished through the use of a taband a pressure sensitive closure placed on the left and right back flapsin a manner similar to those in the front closing gown.

Preferably the gown should be made of a material which is relativelyfluid repellent and is pauticularly suitably made of a laminated scrimreinforced nonwoven material so that they are economically disposable.In addition to the advantages of the gown design thus far described,when the front closing gown of FIGS. 1 through 9 is worn as illustratedin FIGS. 8 and 9, the left front flap 5 underlies the right front flap4, thus a double thickness of this repellent material is provided in thecentral operative field 22 of the gown thus providing two independentbarriers to the passage of blood or other fluids through the gown.Because of the abrasion forces to which the central area of the gown issubjected, one layer of material, even though repellent, is notsufficient to prevent the passage of fluid through this central area ofthe gown, the abrasion reducing its repellency. Since the twooverlapping portions 4 and 5 are not secured together within the centraloperative field 22 of the gown by sewing or the like and since bothportions 4 and 5 are made from continuous sheets of material, there areno thread holes through which fluid may pass.

In the case of a gown which is not double breasted in front, such as aback closing gown, the double thickness of repellent material issuitably provided as shown in FIGS. and 11. An anterior bib 23 underliesthe main sheet 2 in the central operative field and is secured by sewingto the main sheet 2 along the seam 24 between the sleeves 3 and the mainsheet 2, no need-1e holes being present within the central field.

Referring now to FIGS. 12 through 15, there is shown the novel belt unit100 for use with the surgical gown 101. The belt 102 is of generallyelongated rectangular shape and is fan-folded to form a series of loopedfolds 105, stacked one on top of another. By fan-folded it is meant thateach individual fold is independent of any other fold and the belt maybe unfolded by pulling on one end without disturbing the position of anyof the remaining folds.

The folded belt 102 is contained in the sterile overwrap 103. One end104 of the belt extends beyond the stacked folds 105 and also projectsoutward from the sterile overwrap 103. The second end 106 of the beltalso extends past the stacked folds 105 but is contained within thesterile overwrap 103.

Referring now to FIG. 14, when it is time for the surgeon to put on thebelt, the nurse 107 suitably grasps the overwrapped unit at one end soas to have a firm grip on end 106 of the folded belt 102. The potentialbelt wearer 108, being in a sterile condition, then may grasp theprojecting end 104 of the belt. The assistant may then walk around thewearer, thus causing the fan-folded belt to unfold and be extendedaround the surgeon. Upon the assistant again reaching the startingpoint, the surgeon may then grasp the belt with his other hand at thepoint where it projects outward from the sterile overwrap and may removethis final short section from the overwrap and secure the belt. Byvirtue of this procedure, it is not necessary for any nonsterilepersonnel to touch any portion of the belt or gown and it is notnecessary for the surgeon to reach around behind his back.

Specific embodiments of the inventive concept have been described,however, the same should not be construed to limit the invention whichis limited only by the appended claims.

What is claimed is:

1. A surgical gown comprising a main sheet and sleeves connectedintegrally thereto;

said main sheet having a central operative field, said surgical gownadditionally comprising a sheet of fluid repellent material underlyingessentially the entire central operative field of said main sheet andbeing secured to said main sheet only outward of the central operativefield to provide a second independent barrier to the passage of bloodand exudate through that portion of the gown;

said main sheet comprising a back portion and a front portion which inturn comprises left and right flaps, said left flap and said right flapof said front portion overlapping when said gown is worn, said surgicalgown additionally comprising a closure interposed between said rightflap and said left flap when the gown is worn and secured to at leastone of said right flap and said left flap, and means to facilitateaseptic closing of said gown secured to the outer surface of theoverlapping one of said flaps in proxi mate relation to said closure;

said left flap and said right flap of said front portion being foldedoutward upon themselves, the bottom of said gown being folded backwardand upward a plurality of times to form a plurality of underlying folds,and said sleeves being tucked between a pair of said underlying folds tosecure the underlying folds to the top of said gown;

said surgical gown additionally comprising a folded belt for use inconjunction with said gown detachably secured to said main sheet, saidbelt being of generally elongated rectangular shape and being fanfoldedupon itself longitudinally a plurality of times, said folds beingstacked one on another, said folded belt unit further comprising anoverwrap, one end portion of said belt projecting from said overwrap sothat it may be gripped by a wearer, said opposite end portion of saidbelt being contained within said overwrap and extending outward of saidstacked fanfolds so that it may be grasped by the wearers assistantthrough said overwrap.

2. A folded surgical gown comprising a main sheet and sleeves integrallyfastened thereto, said main sheet comprising a back portion and a frontportion comprising left and right flaps, said left flap and said rightflap of said front portion being folded outward and backward uponthemselves, the bottom of said gown being folded backward and upward aplurality of times to form a plurality of underlying folds, whereby afolded surgical gown is provided in which a plurality of pockets arepresent on its outer face in which a persons hands may be inserted tolift said gown from a supporting surface and which are eliminated whenthe gown is opened.

3. A folded surgical gown of claim 2 which is additionally foldedbackward upon itself along a line lying between said pockets so thatsaid pockets are on opposing sides of the folded unit, and in which saidsleeves are tucked between the top of said gown and said underlyingfolds, whereby a folded gown is provided which may be lifted from asupporting surface by virtue of said pockets without the gown unfolding.

4. A surgical gown of claim 2 in which said sleeves are tucked between apair of said underlying folds to secure said folds to the top of saidgown whereby a folded gown is provided which may be lifted from asupporting surface by virtue of said pockets without the gown unfolding.

5. The folded surgical gown of claim 2 in which said left flap and saidright flap of said top portion essentially overlie the left and rightside edges of said back portion respectively, and in which the top edgeof said gown overlies at least one of said underlying folds, by virtueof which a folded surgical gown is provided in which essentially onlyinterior surfaces of the gown are exposed.

6. The folded surgical gown of claim 2 additionally comprising a tabdetachably secured to at least one of said right flap and said left flapof said front portion to facilitate the aseptic handling of said gown.

7. A surgical gown comprising a main sheet, said main sheet beingdivided along essentially its entire vertical length to define a leftflap and a right flap and a pair of generally longitudinally extendingedges, said right flap and said left flap overlapping when said gown isworn; said surgical gown additionally comprising a closure interposedbetween said right flap and said left flap when the gown is worn andsecured to at least one of said right flap and said left flap, and meansto facilitate aseptic closing of said gown secured to the outer surfaceof the overlapping one of said flaps in proximate relation to saidclosure, whereby a surgical gown is provided which may be rapidlyaseptically closed.

8. A surgical gown of claim 7 in which said closure is a pressuresensitive closure and in which said closure is secured to said flap inproximate relation to the generally longitudinally extending edge ofsaid overlying flap and to the top of said gown.

9. A surgical gown of claim 8 in which said means to facilitate asepticclosing of the gown is a tab detachably secured to said flap so that itmay be disconnected therefrom during the closing of said gown, whereby agown is provided which is designed primarily to be aseptically closed byan assistant to the wearer.

10. A surgical gown of claim 9 in which said tab comprises a foldedoverwrapped belt designed for use in conjunction with the wearing ofsaid gown.

11. A surgical gown of claim 8 in which said means to facilitate asepticclosing of the gown is a pocket adapted to receive a persons hand,whereby a gown is provided which is designed primarily to be aspeticallyclosed by the wearer.

12. The surgical gown of claim 11 additionally comprising a pocketadapted to receive a persons hand on the outer surface of the underlyingOne of said flaps.

13. A surgical gown of claim 11 additionally comprising a tab detachablysecured to said overlying flap in proximate relation to said pressuresensitive closure.

14. A surgical gown comprising a main sheet having a central operativefield and sleeves integrally fastened to said main sheet only outward ofsaid central operative field, said main sheet being fluid repellentwithin said central operative field, said surgical gown additionallycomprising a sheet of fluid repellent material underlying essentiallythe entire central operative field of said main sheet and being securedto said main sheet only outward of the central operative field, wherebya surgical gown is provided having at least a double thickness ofrepellent material in the central operative field of the gown whichprovides separate and independent barriers to the passage of blood andexudate through that portion of the gown.

15. A surgical gown of claim 14 in which said main sheet comprises afront portion and a back portion, said front portion comprising a leftflap and a right flap, one of said right flap and said left fiapoverlying the other of said flaps throughout essentially the entirecentral operative field of said gown.

16. A surgical gown of claim 14 in which each of the "underlying sheetand the central operative field of said main sheet comprises a singlecontinuous sheet of material.

References Cited UNITED STATES PATENTS 2,402,982 7/1946 Steenbergen206-632 3,011,172 12/1961 Tames 21-114 X 3,045,815 7/1962 Abildgaard20663.2 3,196,459 7/1965 De Grazia 22 X RICHARD J. SCANLAN, JR., PrimaryExaminer.

2. A FOLDED SURGICAL GOWN COMPRISING A MAIN SHEET AND SLEEVES INTEGRALLYFASTENED THERETO, SAID MAIN SHEET COMPRISING A BACK PORTION AND A FRONTPORTION COMPRISING LEFT AND RIGHT FLAPS, SAID LEFT FLAP AND SAID RIGHTFLAP OF SAID FRONT PORTION BEING FOLDED OUTWARD AND BACKWARD UPONTHEMSELVES, THE BOTTOM OF SAID GOWN BEING FOLDED BACKWARD AND UPWARD APLURALITY OF TIMES TO FORM A PLURALITY OF UNDERLYING FOLDS, WHEREBY AFOLDED SURGICAL GOWN IS PROVIDED IN WHICH A PLURALITY OF POCKETS AREPRESENT ON ITS OUTER FACE IN WHICH A PERSON''S HANDS MAY BE INSERTED TOLIFT SAID GOWN FROM A SUPPORTING SURFACE AND WHICH ARE ELIMINATED WHENTHE GOWN IS OPENED.